Healthcare Provider Details

I. General information

NPI: 1982925517
Provider Name (Legal Business Name): SCOTT W KEMP D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 WATERMELON RD
NORTHPORT AL
35473-5166
US

IV. Provider business mailing address

4310 WATERMELON RD
NORTHPORT AL
35473-5166
US

V. Phone/Fax

Practice location:
  • Phone: 205-330-5266
  • Fax: 205-330-9915
Mailing address:
  • Phone: 205-330-5266
  • Fax: 205-330-9915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO.1228
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: